For many individuals diagnosed with severe cases of scoliosis, the only available treatment option is spinal fusion surgery. This, of course, can be quite daunting and worrying, especially if the patient is young or has never undergone any sort of surgical procedure before.
The bone graft applied during spinal fusion surgery causes the bones in the spine to fuse together over a period of time. This fusion aims to stop movement between the vertebrae, providing long-term stability within the spine.
Spinal fusion has just a 2-3% risk of complications; however, as with any other surgical procedure, problems do occasionally arise once the operation is complete. If you’re thinking of undergoing spinal fusion surgery for your scoliosis and would like to know more about possible long-term side effects, here are some of the things you may potentially experience.
Failed Back Surgery Syndrome (FBSS)
One of the most common problems encountered after spinal fusion surgery – or any type of surgery involving the back – is failed back surgery syndrome. This is a misnomer; FBSS is not actually a ‘syndrome’ but a very generalised term that is often used to describe the condition of patients who have not had a successful result with spinal or back surgery and have experienced continued pain post-surgery.
Surgeons are not able to physically ‘cut out’ the pain felt by patients. They are only able to alter the patient’s anatomy. In most cases, the number one reason why back and spinal surgeries are not effective (and have to be repeated) is because the area that was operated on was not actually the cause of the patient’s pain.
Pseudarthrosis of the spine can result from a failed spinal fusion and may occur at any place where spinal fusion was attempted. It presents itself as either a pain in the neck or back (axial) area or radical (arm and leg) pain that occurs months or years after a previous spinal fusion.
During spinal fusion surgery, if the bones do not fuse together properly through the bone graft, then motion may continue across that area. For some individuals, the motion can cause pain similar to that of a broken bone that never heals.
Patients with metabolic disorders such as diabetes are at increased risk for the development of pseudarthrosis. Smoking is a common risk factor. Some surgeons may even refuse to operate on smokers as it poses such a great risk for failed fusion. Other factors of failure include obesity, chronic steroid use, osteoporosis and malnutrition.
The choice and use of fusion material, number of fusion levels, surgical technique and instrumentation have also all been shown to influence the rate of success and impact quality of life after spinal fusion.
Infection is another problem that can sometimes occur after spinal fusion surgery. Infections can be classified by the anatomical location involved: either the vertebral column, the spinal canal, intervertebral disc space or the adjacent soft tissues. Infection may occur as a result of bacteria or fungal organisms; most post-surgery infections occur between three days and three months after the operation.
Vertebral osteomyelitis is the most common form of spinal infection, developing from direct open spinal trauma, infections in surrounding areas, and from bacteria that spreads from the blood to the vertebrae.
Other common problems that can occur as a result of spinal fusion surgery are:
- Anaesthetic complications
- Paralysis (very rare)
Alternatives to spinal fusion surgery
Here at Scoliosis SOS, we have had success in treating patients who have been diagnosed with severe scoliosis (40-50 degrees and over) with our non-surgical, exercise-based ScolioGold programme. If you’re worried about some of the potential long-term side effects of spinal fusion surgery, and you’d like to try non-surgical treatment first, be sure to get in touch with us.
Spinal fusion recovery
If, however, you have already undergone surgery but are still experiencing some pain, our physical therapy programme can still help you.